Nursing homes and preventable mistakes

Thursday

Mar 13, 2014 at 12:01 AMMar 13, 2014 at 3:45 PM

For anyone who has ever had a loved one in a nursing home or is contemplating that possibility, this should be pretty terrifying. We’re talking about a report by Medicare’s inspector general released this month finding that one in three nursing home patients were harmed by medication errors, infections or injuries. And, said doctors who reviewed the report for a news organization, almost six in 10 cases were preventable.

What that means seems obvious: With a little effort, better training and well-followed procedures, many of those patients wouldn’t have had to suffer additional treatment or re-hospitalization. Pro Publica, a nonprofit journalism website that specializes in investigative reporting, ran a story outlining some of the more salient findings and talked to doctors about what it all means.

In short, we’re not doing a very good job when it comes to ensuring the safety and care of our frailest residents. The inspector general’s report looked at only 653 medical records but that was enough of a sample to project that the frequency translates into about 21,777 patients suffering some sort of harm from substandard care during August 2011, the period reviewed, and as many as 1,538 died. That’s a one-month period, and the focus was only on patients receiving “skilled care” within 35 days of being released from a hospital.

Imagine what the figures would be if they included long-term patients, many of whom are too feeble or afflicted with dementia to be their own advocates.

Much news coverage was devoted to studies a few years ago outlining the risk of medical errors, medicine mix-ups and contracting resistant bacterial infections in hospitals. Since then regulators and hospitals have worked diligently to reduce those cases — mostly by emphasizing prevention and religiously following procedures.

Now it’s time to look at something else.

This study found that the odds are even worse in nursing homes. Many of these errors are the result of understaffing, inadequate training, negligence and lack of or failure to follow procedures. In many cases nursing homes and their staffs do the best they can with limited resources, but these things happen even in the best-administered facilities.

Doctors who have reviewed the Medicare study insist it is possible to reduce the number of preventable injuries and infections in nursing homes. It should be a priority, because doing so is good for the patient, their families, the nursing home and the taxpayers.

Accidents, medical mistakes and infections affect more than the patient, who deserves better. They cost our entire health care system by necessitating additional treatment and, often, readmission to the hospital. The study estimated that preventable injuries cost Medicare and patients about $208 million in that single month. Over a year’s time that’s almost $2.5 billion.